Kornimate/medical-research-clean huggingface dataset:
automated physician notifications to improve guideline-based anticoagulation in atrial fibrillation

Conditions: Atrial Fibrillation

Summary: the overall goal is to improve outcomes among patients with atrial fibrillation (af) by preventing stroke. the investigators propose to implement an automated algorithm using electronic medical record (emr) data to alert physicians in a large primary care practice network at the massachusetts general hospital (mgh) of their patients with af and elevated stroke risk that are not taking an anticoagulant for stroke prevention. the investigators hypothesize that interventions to notify physicians of such individuals may prompt reassessment for the need for anticoagulation, and thereby increase guideline-indicated anticoagulation rates. additionally, in a survey component, physicians will characterize reasons for not pursuing anticoagulation in af patients at elevated risk for stroke.

the overall goal is to improve outcomes among patients with atrial fibrillation (af) by preventing stroke. the investigators propose to implement an automated algorithm using electronic medical record (emr) data to alert physicians in a large primary care practice network at the massachusetts general hospital (mgh) of their patients with af and elevated stroke risk that are not taking an anticoagulant for stroke prevention. using a medical record algorithm, there are an estimated 2,000 to 3,000 such patients in the primary care practices at mgh. the investigators hypothesize that interventions to notify physicians of such individuals may prompt reassessment for the need for anticoagulation, and thereby increase guideline-indicated anticoagulation rates. the investigators define the following three specific aims to address the primary study hypothesis: specific aim 1: implement an automated alerting system within the emr to notify primary care physicians (pcps) of patients with af at elevated stroke risk that are not being treated with anticoagulants. to maximize efficiency of the effort, the alert will not require a concurrent clinic visit, but rather will occur with existing data aggregated from the medical record independent of any clinical encounter. specific aim 2: test whether the alerting system increases the rate of anticoagulation at 3 months after implementation. specific aim 3: characterize the reasons for not pursuing anticoagulation in af patients at elevated risk for stroke. specific aim 4: assess how pcps want to be alerted about anticoagulation status in the future and what types of support they find helpful

Eligibility criteria:
inclusion criteria: * adult patients 18 and older seen in massachusetts general hospital primary care practices in the past 3 years * diagnosed with atrial fibrillation * increased risk of stroke (cha2ds2vasc score ≥ 2) * not currently taking an anticoagulant exclusion criteria: * patients who are subsequently identified as having died prior to or during the course of the study intervention using the social security death index * listed in the massachusetts general hospital system as having a pcp outside of the network
a clinical trial to determine the most suitable dose of opb-111001 in patients with advanced cancer

Conditions: Prostate Cancer; Salivary Gland Cancer; Endometrial Cancer; Squamous Cell Carcinoma of the Cervix; Breast Cancer; Ovarian Cancer

Summary: the purpose of this study is to determine the tolerability profile of opb-111001 and to determine the most suitable dose of opb-111001 in patients with advanced cancer


Eligibility criteria:
inclusion criteria: * ≥ 18 years of age * patients with prostate cancer that is recurrent or did not respond to previous hormone therapy and/or who have exhausted standard treatment options. for the dose escalation parts only: patients who have exhausted standard treatment options with recurrent or refractory cancer (ovarian cancer, cervical squamous cell carcinoma, breast cancer, salivary gland cancer, endometrial cancer) * histologically or cytologically documented diagnosis of cancer * measurable disease according to recist version 1.1 or for prostate cancer also evaluable disease according to prostate cancer working group 2 (pcwg2) eligibility criteria or for ovarian cancer also evaluable disease (non-measurable) according to gynaecologic cancer intergroup (gcig) criteria * absolute neutrophil count ≥1.5 (1500/mm3) and platelets ≥100 × 109/l (without platelet transfusion within the last 4 weeks before first study drug administration), and haemoglobin ≥9 g/dl at screening * alanine aminotransferase and aspartate aminotransferase ≤2.5 × the upper limit of normal (uln), total bilirubin ≤1.5 × uln (exception: patients with liver metastasis are allowed to have aspartate aminotransferase ≤5 × uln and alanine aminotransferase ≤5 × uln) at screening * albumin ≥26 g/l at screening exclusion criteria: * concurrent prior treatment-related toxicity of grade 2 or higher. exception: any toxicity that is in the view of the investigator not a clinically significant safety risk for investigational medicinal product (imp) administration. * previous treatment with cytotoxic chemotherapy or other anticancer therapy within 4 weeks before the first dosing with study drug (at least 6 weeks for mitoxantrone, nitrosurea, and bicalutamide). * treatment with systemic glucocorticosteroids of more than a 2 mg dexamethasone equivalent per day or in cases of treatment with ≤2 mg dexamethasone equivalent per day: 1. dosing was changed within 6 weeks before screening or 2. the patient's cancer is responding to glucocorticosteroid intake * radiation therapy within 4 weeks prior to the first dosing with imp. * treatment with a systemic imp in a clinical trial within 28 days before the screening visit. * current or past history of clinically significant gastrointestinal disease or major gastrointestinal surgery, malabsorption syndrome, or other conditions that could interfere with enteral absorption. * concurrent clinically significant unrelated systemic illness (e.g., serious infection) or significant pulmonary, hepatic, or other organ dysfunction that would compromise the patient's ability to tolerate study treatment or would likely interfere with study procedures or results.

Keywords: prostate cancer
safetim-needs : exploring adolescent's and parent's needs during transition in french cf centers

Conditions: Cystic Fibrosis; Adolescent Behavior

Summary: prospective multicentric study protocol in french cf center, exploring adolescent avec parents needs during transition from pediatric cf center to adult cf center

adolescent's and parent's needs will be studied, before the transition and their experiences of transition, in order to propose organizational national recommendations semi structured interview with adolescents and parents separately, before and after transition. semi structured interviews will be conducted twice for each (adolescent and parents), the first in the 6 months before transition and the second in the 6 months after transition. after their verbatims will be analyzed and the optimal organisation will be determined for the transition based according to their point of view. at the end, the data from this study will be matched with data collected in a former study from care givers practices during transition in the french cf centers.

Eligibility criteria:
inclusion criteria: * cf adolescent and their parents , for whom the transition to the adult center is scheduled within six months and witch have freely agreed to participate in the interviews exclusion criteria: * none

Keywords: transition care program needs
effect of baby massage on postnatal maternal attachment and depression

Conditions: Postpartum Period

Summary: this study aims to examine the effects of providing infant massage training to mothers in the early postpartum period with the goal of preventing postpartum depression and enhancing maternal bonding.

postpartum depression is a common and serious mood disorder influenced by various factors. the global prevalence of postpartum depression has been identified as 17.22%. depressive symptoms experienced by the mother can affect her daily activities and have a negative impact on infant care. postpartum depression can also affect mother-infant bonding. a healthy bond between the mother and the baby supports the baby in feeling secure, emotionally satisfied, and adapting to the world. infant massage has been encouraged in recent years for mothers as it can create positive effects on both depression and maternal attachment. this study provided infant massage training to mothers in the early postpartum period with the aim of preventing postpartum depression and enhancing maternal attachment. the edinburgh postnatal depression scale (epds) was administered to participants on the 14th day postpartum, and those with a score of 12 or below were included in the study. a total of 70 participants were randomly assigned to either the experimental group (35 participants) or the control group (35 participants). the experimental group received a 5-week international association of infant massage (iaim) infant massage program starting from the 14th day postpartum. the control group did not receive any training or intervention. at the end of the 5 weeks, participants were assessed using the edinburgh postnatal depression scale and the maternal attachment inventory. the study examined whether there were differences in the mean scores of the scales between the groups.

Eligibility criteria:
inclusion criteria: * primiparous * singleton pregnancy * delivery at term (37-42 weeks of gestation) * edinburgh postnatal depression scale score ≤ 12 * no physical health issues preventing massage * no history of psychiatric illness (self-reported) * at least basic literacy * residing in ankara * no previous training in infant massage * speaking the same language as the researcher * absence of any anomaly, malformation, or health issue preventing massage (for infants) exclusion criteria: * not having completed the infant massage training * wanting to withdraw from the study for any reason

Keywords: depression, postpartum attachment massage infant nursing
nupro sensodyne prophylaxis paste with novamin sensitivity relief study

Conditions: Tooth Hypersensitivity

Summary: the study is intended to verify through clinical measurement that the nupro sensodyne prophylaxis paste with novamin provides immediate sensitivity relief as well as extended relief up to 28 days.

it is hypothesized that the prophy paste with novamin will give patients immediate sensitivity relief, as well as sensitivity relief up to 4 weeks (28 days) after measurement.

Eligibility criteria:
inclusion criteria: * availability to complete in the 28 day duration. * two sensitive teeth, which are not adjacent to each other and preferably in different quadrants, which demonstrate cervical erosion, abrasion and gingival recession. * qualifying response to tactile stimuli as defined by a score of \</= 20 grams. * qualifying response to air blast stimuli as defined by a score of \>/= 1 on the schiff cold air sensitivity scale. * subjects need to satisfy the qualifying response to stimuli for both parameters assesses (tactile or air blast) on at least two teeth (non-adjacent) to be entered into the study. * good general health with no known allergies to products being tested. * use of a non-desensitizing dentifrice for 2 weeks prior to entry into the study. * subjects must have a minimum of 10 natural teeth, excluding 3rd molars. exclusion criteria: * individuals who exhibit gross oral pathology. * females who may be pregnant or lactating or intending to become pregnant. * individuals who require anesthetic during scaling. * dental pathology which may cause pain similar to tooth sensitivity. * individuals with large amounts of calculus. * subjects with active infectious diseases such as hepatitis, hiv, or tuberculosis. * any condition requiring antibiotic prophylaxis for dental treatment. * excessive gingival inflammation. * individuals who had their teeth cleaned within 30 days of the screening appointment. * individuals who have had desensitizing treatment or tooth bleaching within 90 days of screening appointment. * oral pathology, chronic disease, or history of allergy to test products. * advanced periodontal disease or treatment for periodontal disease (including surgery) within the past twelve months. * sensitive teeth with mobility greater than one. * teeth with extensive/defective restorations (including prosthetic crowns), suspected pulpitis, caries, cracked enamel, or used as abutments for removable partial dentures. * regular use of sedatives, anti-inflammatory drugs, or analgesic. * participation in a desensitizing dentifrice study or regular use of a desensitizing dentifrice within the past 4 weeks. * current participation in any other clinical study or receipt of an investigational drug within 30 days of the screening visit at the start of the study. * personnel; a) an employee of the sponsor; b0 a member or relative of teh study site staff directly involved with the study.
is carotid-vertebral doppler ultrasonography necessary for patients with vertigo?

Conditions: Vertigo; Carotid Artery Diseases

Summary: this study will be carried out prospectively on patients who applied to the cardiovascular surgery polyclinic and the carotid-vertebral artery doppler ultrasound due to the vascular problem. all patients will fill "balance disorder scan survey" and "vertigo-dizziness imbalance questionnaire-ss". patients who score 1 and more are directed to the ear nose throat polyclinic and detailed differential diagnosis. those who score 0 will be in control group.

right and left carotid artery flow velocities, intima-media thicknesses (imt), presence of plaque, vertebral artery flow velocities, and vertebral artery resistance indexes (ri) will be recorded in all patients. risk factor analysis, vertigo symptom scale (vss) and dizziness handicap inventory (dhi-s) questionnaires will be applied to the patients in the ent outpatient clinic. the differential diagnosis of vertigo will be made by performing detailed balance examinations and advanced balance tests.

Eligibility criteria:
inclusion criteria: * all patients who have a vascular problem and doppler usg. exclusion criteria: patients with impaired cooperation, history of malignancy, presence of central nervous system pathology, presence of neurological disease affecting balance in the history, patients whose use of glasses may cause problems (epilepsy, vision loss, etc.) were excluded from the study.

Keywords: vertigo imbalance doppler ultrasonography carotid artery vertebral artery
oncological differences between transanal and laparoscopic total mesorectal excision for rectal cancer.

Conditions: Rectum Cancer

Summary: the primary purpose of this study is to compare the differences of oncological in rectal cancer patients undergoing laparoscopic or transanal endoscopy radical resection. the secondary purpose is to compare the effect of two different surgical methods on prognosis.

transanal total mesorectal excision (tatme) is a new surgical procedure for total mesorectal excision (tme) by dissociating the mesorectum from the bottom through transanal endoscopic. the characteristics of tatme are mainly summarized as transanal reverse operation, no auxiliary abdominal incision, complete mesorectal excision and specimen removal through the anus. so tatme is a natural orifice specimen extraction procedure (noses). however, similar to noses, the specific surgical approach to tatme surgery may raise oncological safety concerns. due to the premature contact with the tumor, the squeezing of the tumor cannot be avoided during the operation. the tumor may also be squeezed when the specimen is removed through the anus, putting the tumor cells at risk of shedding into the abdominal and pelvic cavity. whether tatme is safe and feasible still needs strong evidence-based medical evidence. however, there have been prospective studies related to oncological in noses surgery, but there is a lack of prospective clinical studies on the issue of oncological diffusion during tatme surgery. therefore, the investigators conducted a randomized controlled study to collect the abdominal and pelvic irrigation fluids in the transanal and laparoscopic tme surgery for oncological examination, to clarify the influence of the two different surgical methods on the intraoperative oncological diffusion. the purpose of this study was to clarify the effect of two different surgical methods on intraoperative tumor cell proliferation, and to compare the long-term oncological outcomes of the two surgical methods, so as to provide more evidence-based medical evidence for the safety of tatme surgery.

Eligibility criteria:
inclusion criteria: * primary rectal carcinoma * single lesion * no metastasis exclusion criteria: * history of malignant tumors * acute bowel obstruction, bleeding or perforation * tumor over 6cm in diameter or in severe adhesion with surrounded tissues * severe other contradictions of surgery * pregnant women will be excluded
evaluation of infarct size with 3d rotational angiography

Conditions: Myocardial Infarction

Summary: the size of the infarct is particularly important prognostic marker. it is clearly established that the extent of the infarct is not only correlated to mortality, but also long-term adverse events. the evaluation of the infarct size at the acute phase of the disease is therefore an essential clinical tool to adapt the immediate treatment and follow-up of patients. it is therefore crucial to have techniques that are effective, precise, reproducible, and easily performed during the acute phase to quantify the size of the infarct following angioplasty. myocardial scintigraphy and cardiac mri have been the standard examinations for the evaluation of infarct size. however, these exams are difficult to perform during the acute phase of the infarct owing to difficulties in monitoring unstable patients and the limited availability of the apparatus. it is for this reason that the investigators would like to investigate the rotational angiography (ra), which is comparable to a scanner in its mode of action but does not require transfer of patients as performed using the same apparatus that used for diagnostic coronarography and therapeutic angioplasty. ra is a radiological technique that uses the system employed for coronagraph, and consists rotating the fixed c-arm around the patient and acquisition of a series of images that are then reconstituted. the investigators propose to evaluate the size of the infarct using ra in comparison with cardiac mri (standard examination) performed as soon as possible after ra and the investigators hope to demonstrated that ra allows the measurement of an infarct as precisely as cardiac mri.


Eligibility criteria:
inclusion criteria: * admitted for myocardial infarction and fulfilling the following criteria: * transitory or persistent st elevation * coronary occlusion (timi 0) treated by angioplasty or thrombotic acute stenosis treated or not by angioplasty * planned coronarography * with social security coverage * not under any legal protection; * the consent form signed. exclusion criteria: * patient unconscious or confused; * presenting: * cardiogenic shock; * or signs of cardiac insufficiency; * or sustained cardiac arrhythmia; * or atrial fibrillation; * or sustained extrasystole; * or high degree block; * contraindication for mri; * known history of hypersensitivity to mri contrast agent; * risk of pregnancy or proven pregnancy based on interview data; * breast feeding; * patient subject to legal guardianship by a court; * incapacity to express consent; * patient not or badly understanding french.

Keywords: myocardial infarction mri rotational angiography
short-term effects of carbohydrate-restricted diet on glycemic and metabolic control among children and adolescent with type 1 diabetes mellitus

Conditions: Type 1 Diabetes

Summary: the current management of type 1 diabetes mellitus (t1dm) involves the use intensive insulin therapy, frequent blood glucose monitoring and carbohydrate counting. there is a need to strengthen some of the t1dm management aspects as dietary intervention in order to achieve better glycemic and metabolic control. the international society for pediatric and adolescent diabetes (ispad) recommend that children and adolescents with t1dm have about 50% of their total daily caloric requirement from carbohydrates. however, an alternative approach is emerging in recent years. the use of low-carbohydrate diet is suggested to reduce postprandial hyperglycemia and glycemic variability and lower the required insulin.


Eligibility criteria:
inclusion criteria: * children and adolescents aged 10 - 18 years, diagnosed with t1dm for at least 1 year attending the pediatric diabetes clinic at sohag university hospital and using the mdi regimen and carbohydrate counting methods are eligible for the study. exclusion criteria: * children and adolescents with associated diseases such as autoimmune hypothyroidism or celiac disease and those with diabetes-related complications such as diabetic neuropathy, retinopathy or nephropathy will be excluded.
safety and efficacy study of icotinib with intensity-modulated radiotherapy in nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: nasopharyngeal carcinoma (npc) is a prevalent disease in southeast of china. radiation therapy with or without chemotherapy is a standard therapy for nasopharyngeal cancer. cytotoxic chemotherapy plays an important role in the curative treatment of advanced npc. however, concurrent chemoradiotherapy increased significantly local and systemic toxic effects, which may preclude many patients from proceeding with combined therapy. the epidermal growth factor receptor(egfr) gene is amplified in 40% and egfr protein is overexpressed in over 80% of npc. egfr overexpression is also associated with shorter survival following chemoradiotherapy in locoregionally advanced npc. and some basic researches have proved that egfr tyrosine kinase inhibitors(tkis) could increase the radiosensitivity and reduce the epithelial-mesenchymal transition (emt) in npc cell line. moreover, distant metastases has been the major cause of treatment failure in npc. icotinib hydrochloride is a novel oral egfr tkis with low mammalian toxicity(made in china). but base on toxic effects of icotinib, it may increase toxic effects about skin and mucosa in combination therapy with icotinib and intensity-modulated radiotherapy (imrt). the prospective study will assess the tolerability and efficacy of icotinib combined with imrt in patients with npc. this regimen is of great interest and it has potential to alleviate the adverse effects, improve patient compliance and better therapeutic ratio.


Eligibility criteria:
inclusion criteria: 1. patients with histological proof of squamous carcinoma of the nasopharynx. 2. patients must have ecog performance status of 0-1. 3. patients should have adequate bone marrow function defined as an absolute peripheral granulocyte count (agc) of \>/= 1500 cells/mm3, platelet count of \>/= 100,000 cells/mm3; adequate hepatic function with bilirubin \ /= 50 ml/min and inr 0.8 - 1.2. 4. patients must sign a study specific informed consent form prior to study entry. exclusion criteria: 1. evidence of metastases by clinical or radiographic examinations. 2. history of malignancy other than non-melanoma skin cancer. 3. prior chemotherapy or anticancer biologic therapy for any type of cancer, or prior radiotherapy to the head and neck region except for radioactive iodine therapy. 4. patients with uncontrolled intercurrent disease. 5. patients with currently active malignancy. 6. pregnant or lactating women female patients of childbearing potential who are unwilling to practice adequate contraception during study treatment and for two months after the last administration of study drug.

Keywords: nasopharyngeal carcinoma(npc) icotinib intensity modulation radiation therapy(imrt)